Primary uterine serosal pregnancy with myometrial invasion.

Kang, Min Jung; Joo, Jung Kyung; Kang, Ji Hyun; Joo, In Sook; Park, Yangsoon; Seo, Kyoung Young

doi:2012.55.3.213

Case Report

Korean Journal of Obstetrics & Gynecology 2012;55(3):213-217.
DOI: https://doi.org/10.5468/KJOG.2012.55.3.213 Published online March 1, 2012.

Primary uterine serosal pregnancy with myometrial invasion.

Min Jung Kang, Jung Kyung Joo, Ji Hyun Kang, In Sook Joo, Yangsoon Park, Kyoung Young Seo

¹Department of Obstetrics and Gynecology, Veterans Health Service Medical Center, Seoul, Korea. kvhsky@hanmail.net
²Department of Pathology, Veterans Health Service Medical Center, Seoul, Korea.

Abstract

Ectopic pregnancy is reported to be 1.5%-2% of all pregnancies. Ectopic pregnancy varies with the site of implantation; abdominal pregnancy has been reported to occur in approximately 1% of patients with ectopic pregnancy. Especially, uterine serosal pregnancy is an extremely rare form of abdominal pregnancy. Although variable diagnostic imaging methods have been developed, accurate diagnosis of the abdominal pregnancy using noninvasive imaging study is still difficult. Delayed diagnosis leads to high maternal morbidity and mortality in relation to massive bleeding. Therefore, diagnostic laparoscopy or laparotomy is generally considered to patients with uncertain diagnosis of the abdominal pregnancy. We experienced a case of primary uterine serosal pregnancy that had a rupture of gestational sac with myometrial invasion. We finally confirmed a definite site of the ectopic pregnancy through laparoscopic exploration. That precise location could be not found by pelvic ultrasonography and magnetic resonance imaging. The patient underwent a subtotal hysterectomy.

Key Words: Ectopic pregnancy, Abdominal pregnancy, Uterine serosal pregnancy, Diagnostic laparoscopy